Jesse Ryan Cardin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

64271 Issued in TX

Practice address

11-3784 2ND St
Volcano, HI 96785

Phone

(210) 527-8755

Fax

(210) 714-9757

NPI assigned

Oct 6, 2019

Last updated

Jul 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Awaken Insight

  • Clinical Social Worker
  • Volcano, HI
  • NPI 1689216616

  TX

  Medicare reassignment NPD Authorized official
• Awaken Insight Counseling Licensed Clinical Social Worker PC

  dba Awaken Insight Counseling

  • Clinical Social Worker
  • Laguna Beach, CA
  • NPI 1952251225

  TX

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1801437314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 JACKSON KELLER RD",
            "address_2": "PMB 3081",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78213",
            "telephone_number": "210-527-8755",
            "fax_number": "210-714-9757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11-3784 2ND ST",
            "city": "VOLCANO",
            "state": "HI",
            "postal_code": "96785",
            "telephone_number": "210-527-8755",
            "fax_number": "210-714-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDIN",
        "first_name": "JESSE",
        "middle_name": "RYAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61390269",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-5041",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahua Life Counseling, LLC
• Awaken Insight
• Anne Marie Leilani Briggs, LMHC
• Nicole Bulacan
• Compassion Focused Therapy LLC
• Christin Decoito
• Elizabeth Fenton, LMT
• Gentle River Healing LLC
• Heart2Heart Counseling LLC

• Clinical Social Worker in Volcano, HI
• Providers in Volcano, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.